Journal List > J Korean Surg Soc > v.77(5) > 1011028

TOOLS
Jun, Jung, Kim, Jun, Chin, and Park: Comparison of Clinical Outcomes between Laparoscopic and Open Appendectomy: A Retrospective Analysis of 2,745 Patients
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(5): 320-325.

Published online: 5 November 2009

DOI: https://doi.org/10.4174/jkss.2009.77.5.320

Comparison of Clinical Outcomes between Laparoscopic and Open Appendectomy: A Retrospective Analysis of 2,745 Patients

Ye-Won Jun, M.D., Hun Jung, M.D., Sung-Jeep Kim, M.D., Kyong Hwa Jun, M.D., Hyung Min Chin, M.D., Woo Bae Park, M.D.

Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.

Corresponding author (dkkwkh@catholic.ac.kr)

Received 29 July 2009       Accepted 27 August 2009

Copyright © 2009 The Korean Surgical Society

Abstract

Purpose

Despite the reported advantages of laparoscopic appendectomy (LA), there is debate about the postoperative complication rates. Our study attempts to determine if laparoscopic appendectomy is safe and feasible compared with open appendectomy (OA).

Methods

A retrospective review was conducted of all patients who underwent open appendectomy (OA, 2,109 cases) and laparoscopic appendectomy (LA, 500 cases) at our hospital between 1997 and 2007. Incidental and interval appendectomies were excluded from this study. Demographic data, pathology, operation time, length of hospital stay, days to regular diet, and in hospital complication rate were identified.

Results

The peak age was 27 years. Seven of the 500 were converted to OA, yielding a conversion rate of 1.2%. The presence of non-visualized appendix, adhesion and technical failures were reasons for conversion. The distribution of histological stages of inflammation was comparable in both groups. The mean operating time was longer for the laparoscopic (64 min) than for the open procedure (58 min) (P<0.001). The complication rate after OA (7%) was significantly higher than that following LA (2.8%) (P=0.001). Hospital stay and frequency of analgesic administration were significantly lower in LA group than in OA group.

Conclusion

Laparoscopic appendectomy is a safe and clinically beneficial operating procedure even in patients with appendicitis with peritonitis, perforation and abscess, resulting in shorter hospital stays and lower complication rates.

Keywords: Appendicitis, Open appendectomy, Laparoscopic appendectomy

Figures and Tables

Table 1
Changes of operation method
jkss-77-320-i001
Table 2
Patient distribution according to appendiceal pathology
jkss-77-320-i002
Table 3
Clinical outcome
jkss-77-320-i003
Table 4
Postoperative complications
jkss-77-320-i004
Table 5
Postoperative complications of open appendectomy according to period
jkss-77-320-i005

References

1. Semm K. Endoscopic appendectomy. Endoscopy. 1983. 15:59–64.
2. Nguyen NT, Zainabadi K, Mavandadi S, Paya M, Stevens CM, Root J, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg. 2004. 188:813–820.
3. Apelgren KN, Molnar RG, Kisala JM. Laparoscopic is not better than open appendectomy. Am Surg. 1995. 61:240–243.
4. Minne L, Varner D, Burnell A, Ratzer E, Clark J, Haun W. Laparoscopic vs open appendectomy. Prospective randomized study of outcomes. Arch Surg. 1997. 132:708–711.
5. Nowzaradan Y, Westmoreland J, McCarver CT, Harris RJ. Laparoscopic appendectomy for acute appendicitis: indications and current use. J Laparoendosc Surg. 1991. 1:247–257.
6. Lin HF, Wu JM, Tseng LM, Chen KH, Huang SH, Lai IR. Laparoscopic versus open appendectomy for perforated appendicitis. J Gastrointest Surg. 2006. 10:906–910.
7. Fukami Y, Hasegawa H, Sakamoto E, Komatsu S, Hiromatsu T. Value of laparoscopic appendectomy in perforated appendicitis. World J Surg. 2007. 31:93–97.
8. Frazee RC, Bohannon WT. Laparoscopic appendectomy for complicated appendicitis. Arch Surg. 1996. 131:509–511.
9. Bonanni F, Reed J 3rd, Hartzell G, Trostle D, Boorse R, Gittleman M, et al. Laparoscopic versus conventional appendectomy. J Am Coll Surg. 1994. 179:273–278.
10. Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B. Laparoscopic Appendectomy Study Group. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Am J Surg. 1995. 169:208–212.
11. Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg. 2005. 242:439–448.
12. Cox MR, McCall JL, Toouli J, Padbury RT, Wilson TG, Wattchow DA, et al. Prospective randomized comparison of open versus laparoscopic appendectomy in men. World J Surg. 1996. 20:263–266.
13. Tate JJ, Dawson JW, Chung SC, Lau WY, Li AK. Laparoscopic versus open appendicectomy: prospective randomised trial. Lancet. 1993. 342:633–637.
14. Martin LC, Puente I, Sosa JL, Bassin A, Breslaw R, McKenney MG, et al. Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg. 1995. 222:256–261.
15. Sporn E, Petroski GF, Mancini GJ, Astudillo JA, Miedema BW, Thaler K. Laparoscopic appendectomy--is it worth the cost? Trend analysis in the US from 2000 to 2005. J Am Coll Surg. 2009. 208:179 e2–185 e2.
16. Hellberg A, Rudberg C, Enochsson L, Gudbjartson T, Wenner J, Kullman E, et al. Conversion from laparoscopic to open appendicectomy: a possible drawback of the laparoscopic technique? Eur J Surg. 2001. 167:209–213.
17. Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R. Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc. 2001. 15:660–662.
18. Long KH, Bannon MP, Zietlow SP, Helgeson ER, Harmsen WS, Smith CD, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: Clinical and economic analyses. Surgery. 2001. 129:390–400.
19. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg. 1999. 177:250–256.
20. Tang E, Ortega AE, Anthone GJ, Beart RW Jr. Intraabdominal abscesses following laparoscopic and open appendectomies. Surg Endosc. 1996. 10:327–328.
21. Yau KK, Siu WT, Tang CN, Yang GP, Li MK. Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg. 2007. 205:60–65.
22. Hussain A, Mahmood H, Nicholls J, El-Hasani S. Prevention of intra-abdominal abscess following laparoscopic appendicectomy for perforated appendicitis: a prospective study. Int J Surg. 2008. 6:374–377.
TOOLS
Similar articles